title: Evaluation of somatostatin receptors in large cell pulmonary neuroendocrine carcinoma with 99mTc-EDDA/HYNIC-TOC scintigraphy.
abstract: OBJECTIVE
  Large cell pulmonary neuroendocrine carcinoma (LCNEC) is a poorly differentiated and high-grade neoplasm. It is positioned between an atypical carcinoid and small cell neuroendocrine carcinoma of the lung in a distinct family of pulmonary neuroendocrine tumors. The aim of our study was to detect somatostatin receptors in this uncommon malignancy and to evaluate the sensitivity of somatostatin receptor scintigraphy (SRS) in LCNEC staging.
  
  
  METHODS
  We analyzed data of 26 patients (mean age: 61.5±7.9 years) with histologically confirmed diagnosis of LCNEC, including 18 cases not treated surgically and eight patients after the resection of the primary tumor. SRS was carried out with technetium-99m ethylene diamine-diacetic acid/hydrazinonicotinyl-Tyr3-octreotide (Tc-TOC). A visual analysis of scintigraphic images was done with reference to conventional imaging modalities (computed tomography and bone sicintigraphy).
  
  
  RESULTS
  SRS sensitivity for the detection of primary lesions, supradiaphragmatic metastases, and infradiaphragmatic metastases was 100, 83.3%, and 0%, respectively. Five out of 13 metastases to the liver appeared on SRS as photopenic foci, visible on the background of physiological hepatic activity. Only one of the nine metastases to the skeletal system was found by SRS with sensitivity as low as 11.1%. The overall SRS sensitivity for the detection of secondary lesions and of all lesions was 54.8 and 62.2%, respectively.
  
  
  CONCLUSIONS
  Within a rather large series of LCNEC, the primary tumor showed an uptake of Tc-TOC in all cases, whereas some metastases did show Tc-TOC uptake and some others did not.
authors.affiliation: Department of Radiology and Nuclear Medicine, Medical University of Lublin, Poland. ampolak@o2.pl
authors.forename: Anna
authors.initials: A
authors.lastname: Nocuń
authors.forename: Beata
authors.initials: B
authors.lastname: Chrapko
authors.forename: Renata
authors.initials: R
authors.lastname: Gołębiewska
authors.forename: Bogusław
authors.initials: B
authors.lastname: Stefaniak
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Czekajska-Chehab
mesh_terms: D000368:Aged; D018278:Carcinoma, Neuroendocrine / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015609:Organotechnetium Compounds / Q000737:chemistry; D011877:Radionuclide Imaging; D017481:Receptors, Somatostatin / Q000378:metabolism*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013004:Somatostatin / Q000031:analogs & derivatives
chemical_list: D015609:Organotechnetium Compounds; D017481:Receptors, Somatostatin; C487389:technetium 99m EDDA-HYNIC-Tyr(3)-octreotide; D013004:Somatostatin